System and method for real time viewing of critical patient data on mobile devices

ABSTRACT

A data-processing tool for displaying real-time patient data on remote and/or mobile devices. The tool renders graphical data on the screen of the remote device in a manner that makes it practical for the health care provider to review the data. Charting components provide landscape support, an ability to overlay patient data and patient images, zoom in/zoom out, custom variable speed scrolling, split screen support, and formatting control. The methodology operates as an asynchronous application, allowing patient data to be streamed in real-time to the handheld device while conserving enough CPU power to simultaneously allow the end user to interact at will with the responsive display application. Finally, the methodology implements an IT management console that allows system managers to monitor the exchange of data between hospital systems and the primary database, including all patient data packets, notifications and alerts, connected remote devices, etc.

CROSS REFERENCE TO CORRESPONDING APPLICATIONS

This application is a continuation of U.S. application Ser. No.11/301,348, filed on Dec. 12, 2005, the disclosure of which is expresslyincorporated herein by reference in its entirety, and which claims thebenefit under Title 35 United Sates Code §119(e) of U.S. ProvisionalApplication No. 60/641,057 filed Jan. 3, 2005.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates generally to systems and methods fortransmitting, receiving and displaying information over wirelesscommunication and data processing devices. The present invention relatesmore specifically to a system and method for collecting, uploading,transmitting, receiving, downloading, manipulating, and displayingmedical patient data to a mobile display device operable by thepatient's physician or health care provider.

2. Description of the Related Art

While physicians and other health care providers currently utilize alarge number of products and systems that benefit from advances inwireless communication technology, there are still significantlimitations to the information that can be transmitted, received, anddisplayed over these devices in a practical and efficient manner. Whiletext messaging and voice communications have been fairly wellestablished in the health care and medical fields, the wirelesstransmission of critical patient data has, for a number of reasons, beenslow to develop. There are many limitations that are intrinsic to mobiledevices, especially those constraints related to speed, performance,memory, and display size. In addition, because of the critical nature ofthe data, it is important that the technology work reliably andefficiently over potentially low speed, low bandwidth, and sometimesintermittent cell phone connections.

Efforts have been made in the past to transmit medical informationthrough various telecommunication means to health care professionals forreview and analysis. These efforts include the following:

U.S. Pat. No. 6,589,170 B1 issued to Flach et al. on Jul. 8, 2003,entitled Medical Telemetry System with Cellular Reception of PatientData. In something of the reverse of the present invention, the Flach etal. disclosure describes a system that collects patient data bytelemetry from wireless patient sensor units. The data is collected andconcentrated in standard hospital network information processingsystems.

U.S. Pat. No. 6,093,146 issued to Filangeri on Jul. 25, 2000, entitledPhysiological Monitoring. Similar to Flach et al., this patent likewisedescribes a system whereby the patient data is wirelessly communicatedto a nearby base station from which the data may then be transmitted (bywire line) to a remotely accessible telephone network.

U.S. Pat. No. 6,302,844 B1 issued to Walker et al. on Oct. 16, 2001,entitled Patient Care Delivery System. The system described in theWalker et al. patent identifies anomalies in collected patient data anddetermines whether it is necessary to contact a physician (by telephone,for example) regarding the anomalous event.

U.S. Pat. No. 6,416,471 B1 issued to Kumar et al. on Jul. 9, 2002entitled Portable Remote Patient Telemonitoring System describes yetanother system for collecting patient data from a wireless sensor deviceon the patient and transmitting it to a nearby base station from whichthe information is sent by standard techniques to a remote monitoringstation.

U.S. Pat. No. 6,336,900 B1 issued to Alleckson et al. on Jan. 8, 2002,entitled Home Hub for Reporting Patient Health Parameters provides foryet another system that collects patient data from wireless transmittingsensors on the patient and places the information/data on a public datatransmission network.

U.S. Pat. No. 6,168,562 B1 issued to Brown on Jan. 2, 2001, entitledRemote Health Monitoring and Maintenance System describes a patientmonitoring system that adds the capability of remotely re-programmingthe sensor system associated with the patient so as to alter the mannerin which it collects patient data.

U.S. Pat. No. 6,475,146 B1 issued to Freiburger et al. on Nov. 5, 2002,entitled Method and System for Using Personal Digital Assistants withDiagnostic Medical Ultrasound Systems. The primary purpose of the systemdescribed in the Freiburger et al. disclosure is to permit the use of aPDA as a source of control information, data, and/or commands to carryout the operation of an ultrasound examination system.

U.S. Pat. No. 6,520,910 B1 issued to Kohls on Feb. 18, 2003, entitledMethod and System of Encoding Physiological Data. This system focuses onthe transfer of high-resolution data to workstations withlower-performance capabilities in order to permit some level of dataanalysis thereon. The patent describes the manipulation of graphic filesfor the purpose of making the high-resolution data more accessible.

U.S. Pat. No. 6,383,137 B1 issued to Berry on May 7, 2002, entitledLabor Alerting Device. This patent describes the use of an implantedmonitor to detect the onset of labor and to transmit a signal to a pageror PDA that notifies the patient or the patient's physician of theimpending birth. The system does not communicate data beyond the simpleevent notification.

U.S. Pat. No. 6,616,613 B1 issued to Goodman on Sep. 9,2003, entitledPhysiological Signal Monitoring System. The Goodman patent describes asystem specifically designed to communicate photoplethysmography (PPG)data from a patient to a system web server for analysis, storage andlater retrieval. The patent is specific to the monitoring of thecirculatory system and endeavors to analyze heart and blood data forremote monitoring.

U.S. Pat. No. 6,641,533 B2 issued to Causey, III et al. on Nov. 4, 2003,entitled Handheld Personal Data Assistant (PDA) with a Medical Deviceand Method of Using the Same. This patent describes the localized use ofa PDA in conjunction with a medical device for the processing of datareceived there from. The system focuses on the ability to remotelyprogram the medical device with the PDA and the snapshot presentation ofdata thereon.

U.S. Pat. No. 5,954,663 issued to Gat on Sep. 21, 1999, entitled FetalMonitoring System and Method describes one system for the collection andstorage of patient data that includes fetal heart rate and uterinecontraction data. The patent addresses the integration of multiplemonitoring systems within a hospital setting but does not discussconditioning the data for transmission over wide area networks orwireless devices.

The above identified systems in the related art variously describeattempts to utilize wireless data communication technologies to transmitmedical information to health care providers, or to condition data suchthat it may be useful for remote monitoring purposes. The ability totransmit real-time graphical data in a discernable form to smallhand-held type devices is noticeably lacking from all of the systemsdescribed. While the collection of patient data and the wirelesstransmission of the same to some local hub has been quite thoroughlyexplored, such systems have no need to consider the ability to displaysuch data in useful form on display systems with lower memory andprocessing capacities such as PDAs. At best the above systems anticipatethe display of snapshots of data that in most circumstances is whollyinsufficient to allow the physician to make a judgment about thecondition of a patient or the proper course of action to take.

It would be desirable to provide a system that is capable oftransmitting patient physiological data over a wide area datacommunications network with a resolution sufficient to provide real-timemonitoring and accurate analysis by a remote physician or health careprovider. It would be desirable if the system could communication morethan a single physiological parameter and could display the same with adiscernable resolution on a small display screen such as may be presenton a PDA or cellular phone. It would be desirable if the system allowedthe remote health care provider not only view the data in real-time butto also scroll backward through the data to identify and characterizetrends in the patient's condition. It would be desirable if the displaycapabilities included features such as landscape/portrait viewing,patient biographical data viewing, patient image viewing, zoom in/outgraphical data viewing, variable speed scrolling and HIPAA compliantinformation security measure. It would be desirable if such a systemcould be implemented using currently available operating systems forhand held data communication devices over currently available bandwidthon established wide area data and telecommunication network systems.

SUMMARY OF THE INVENTION

The development of the present invention stems from the growingrealization of the benefits of viewing real time critical patient dataon mobile devices, such as Pocket PC® handheld devices and other PDA orcellular phone devices, and further from realizing how the utilizationof this capability can dramatically improve overall patient healthcare.The basic system and method of the present invention functionparticularly well with fetal heart and maternal monitoring data, but arecapable of functioning in conjunction with more complex displays such as12-lead EKG data in a manner similar in form and function. In general,the system and method of the present invention can be applied to thetransmission, reception, and display of any type of wave form, rhythm,or “free form” data associated with the physiological condition of apatient.

The methodology of the present invention is made possible in part byrecent developments in certain software platform technologies and thegradual movement to the use of smart client applications in smallwireless devices. The present methodology is built on Microsoft's .NET®platform which is a software platform that connects information, users,systems, and devices, and provides a bridge between clients, servers,and developer tools. The Microsoft .NET® platform is currently beingutilized to build and run various types of software, including web-basedapplications, smart client applications, and XML web services. “Webservices” as used herein, are simply components that facilitate thesharing of data and functionality over a network through standardplatform independent protocols such as XML, SOAP, and HTTP.

The methodology of the present invention incorporates software systemsthat are specifically designed for use in smart client applications. Theterm “smart client” highlights the differences between the typical “richclient” applications commonly utilized in the medical field, and thenext generation of client applications. Smart client applicationscombine the benefits of a rich client model with the benefits of a thinclient model, especially as they relate to mobility, manageability andfunctionality. Smart client applications also provide much moreflexibility than the traditional rich client applications, and can bebuilt to take maximum advantage of the features provided by the hostdevice. In general, smart client applications display the followingcharacteristics:

1. Smart client applications utilize local resources such as the localCPU or GPU, local memory or disk, or other local devices connected tothe client such as a cellular modem, pager vibrator, etc. In addition,they take advantage of locally operable software including variousMicrosoft® applications such as Instant Messenger® and Pocket Outlook®.

2. Smart client applications may generally be referred to as connectedin so far as they generally do not operate in a stand alone mode, andalways form part of a larger distributed system. In this manner thesmart client application may interact with a number of different webservices that provide access to the common or shared application data.

3. Despite the connected operation described above, smart clientapplications are typically offline capable in that they run on the localmachine and are able to function with data or information received evenwhen the user is not immediately connected to a server. An example ofthis in the environment of the present invention may be seen where adoctor may be stepping into an elevator with no wireless connectivityavailable, or a building location where weak cell phone coverage existseven when the client is connected, the smart client application canimprove performance and usability by caching data and managing theconnection in an intelligent way.

4. Smart client applications generally operate with intelligent installand update features. In this way they manage their deployment, andupdate in a much more intelligent way than traditional rich clientapplications. The .NET framework enables application artifacts to bedeployed using a variety of techniques, including simple file copy ordownload over HTTP. Applications may be updated while running, and canbe deployed on demand by browsing to a specific URL. In addition, theMicrosoft .NET® framework provides security mechanisms that insure theintegrity of the application in its related assemblies. Assemblies canbe given limited permissions in order to restrict their functionalitiesin semi-trusted situations.

5. Finally, smart client applications provide client device flexibility.The .NET framework together with the .NET compact framework provides acommon platform upon which smart client applications can be built. Oftenthere will be multiple versions of a smart client application, eachtargeting a specific device type, and taking advantage of the device'sunique features to provide functionality appropriate to its usage. Forexample, a PDA phone can receive an SMS message for an alert coming froma central monitoring system at a hospital, or the application could beconfigured to cause the data phone to vibrate and/or generate an audiblesound when a severe alert is detected and received. The platform onwhich the present invention is based is capable of taking advantage ofall of these device specific features.

The system and methodology of the present invention take advantage ofthe above technologies and add to them significant customized chartingcomponents to provide a useful tool for the viewing of real-timecritical patient data on mobile devices. Currently there are very fewthird party components on the market for PDAs that provide theappropriate functionality necessary for the operation of the presentsystem and method.

The most important requirement to implement the system and method of thepresent invention is the ability to utilize as much screen “real estate”as possible in order to provide a visual graphic display that offersdiscernable data to the health care provider. Working against the cleardisplay of high-resolution data are screen size and display memorycapacities. The present invention optimizes the amount of information(patient data) that can be displayed in a discernable manner on thesmaller screens of typical handheld devices.

In addition to optimizing the display, the efficiency with which adrawing, a figure or a data set is displayed on the screen is crucialbecause any processing time taken to create or draw an image on thescreen is time taken away from data processing which significantlyreduces the overall efficiency of the data communication. The presentinvention therefore seeks to optimize the image rendering process forhandheld device displays.

To achieve these display related objectives, a customized chartingcontrol is established and implemented in the present invention usingthe latest GDI+ and PDA drawing techniques. These charting componentsprovide a number of advantages over existing charting systems on themarket, including landscape support, the ability to overlay patient dataand patient images, zoom in/zoom out, custom variable speed scrolling,split screen support (for example it would not be possible to create theOB Strip without showing both fetal heart rate and maternal contractionsimultaneously), and unlimited control over formatting (changing colors,font sizes, etc). In addition to GDI+, the present invention takesadvantage of GAPI which stands for Game API (Application ProgramInterface), and is a set of protocols and tools that traditionally isonly used for building game software. GAPI is appropriate for use withthe present invention because it provides direct access to the videodisplay memory of the devices running the applications, and thus allowsfor very high-performance and high quality graphic rendering. This notonly allows for a better graphical display but also takes upsignificantly less CPU processing power which is then freed up forbackground processing tasks such as synchronizing data from the hospitalto the PDA. GAPI is also supported on multiple PDA operating systems(Pocket PC®, Palm®, Symbian®, etc.).

In addition to the display related objectives discussed above, thepresent invention seeks to optimize interactive functionality andresponsiveness for the remote physician or health care provider. Manydifferent factors determine how fast network communication services mayrespond to an application making a request, including the nature of therequest, network latency, reliability, the bandwidth of the connection,and how busy the service or services are. All of these factors can causeproblems with the responsiveness of single threaded applications, andcan ultimately result in dissatisfied end users who dislike theapplication (and eventually discontinue its use) due to its slowoperation.

To achieve the responsiveness goals discussed above, the methodology ofthe present invention implements steps that utilize the benefits gainedfrom an asynchronous application, without sacrificing the crucialprocessing time of the handheld device to handle user interfaceactivity. In this manner, the methodology allows the critical patientdata to be streamed in real-time to the handheld device in a backgroundoperation while it still conserves enough CPU power to simultaneouslyallow the end user to interact at will with the responsive applications(for example, looking for trends in the data by scrolling quickly backover a period of several minutes or hours).

The methodology of the present invention is structured using pure objectoriented concepts and design patterns which allow it to achieve superiorperformance and scalability. Each logical tier of the methodology, fromthe data access objects to the charting control objects to the userinterface objects, is structured with precise well defined interfacesthat support enhancements and customization through both interface andimplementation inheritance. In addition, the use of object models inadvanced .NET programming language features such as reflection,delegates, and event handlers, allow the methodology to be customizedfor specific hospital implementation or for specific subject matterapplications.

Finally, the methodology of the present invention implements an ITmanagement console that allows system managers to monitor the exchangeof data between hospital systems and the primary database, including (inthe preferred embodiment) all fetal strip packets, notifications andalerts, connected remote devices, etc. In this manner, hospitaltechnical support staff may as necessary, view the exchange of data andprovide support and troubleshooting to its operation.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a high-level schematic block diagram showing the hardware andsoftware structure for the complete system of the present invention.

FIG. 2 is a mid-level schematic diagram of the data processing andcommunication components of the complete system of the present inventionshowing the various data communication paths, and providing an overviewof the functionality of the system.

FIG. 3 is a high-level schematic block diagram showing the softwarearchitecture for the operation of the system of the present invention,and is a distillation of the object model structure that follows inFIGS. 4A-4D.

FIGS. 4A-4E provide a series of object model architecture diagrams thatdescribe in greater detail the functionality of the system moregenerically described in FIG. 3.

FIG. 5 is a combination diagram showing a representation of a typicalhandheld device appropriate for use within the system of the presentinvention and a plot of the two data sets communicated to the display ofthe handheld device.

FIGS. 6A-6K are screen-shot images of a display associated with atypical handheld device appropriate for use within the system of thepresent invention showing the various functional capabilities of thesystem in providing a versatile display of the patient data.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

Reference is made first to FIG. 1 for a summary overview of the existingand new components necessary for implementation of the system andmethodology of the present invention. FIG. 1 is a top-level schematicblock diagram showing the hardware and software structure for the entiresystem of the present invention from the patient 10 whose physiologicaldata is being monitored to the handheld device 70 utilized by thephysician doing the monitoring. Patient vital signs sensors andelectronics 20 are used to derive the relevant patient physiologicaldata in a manner well known in the art. A variety of known sensors andelectronic monitoring devices have been developed capable of detectingphysiological functions and converting sensed responses into analog anddigital signals containing characteristic information regarding thepatient's vital signs and health conditions.

Also known in the art are methods and systems which bring such patientinformation into the existing hospital patient data collection systemand database 30. Such systems typically collect and store patientinformation (in the form of graphical data and the like) for the purposeof displaying such information at remote hardwired locations within thehospital or in some instances by telecommunication landlines tolocations outside the hospital. The present invention introducesproprietary software and database system 40 which is, in part, thesubject of the present application, into a data processing systemintegrated with or connected to the existing hospital systems 30. Thissoftware and database system 40 of the present invention takes thestandardized graphical data associated with the monitored physiologicalevents and prepares such data for its eventual display on remotewireless devices.

The Internet 50 provides the medium through which the configured andformatted data may ultimately be transmitted to the wireless remotedevices to be displayed for the purpose of allowing a physician toremotely discern the information. From the Internet 50 standard wirelessdata telecommunication technologies 60 come into play to receive theconfigured information from the Internet 50 and provide it to a varietyof different handheld devices 70 represented generically by a display ona PDA.

It is primarily the unique functionality of the proprietary software anddatabase system 40 shown in the overall view of the entire system inFIG. 1 and the associated software present in the handheld device 60that constitute the novel capabilities of the system of the presentinvention. While the present invention takes advantage of currenttechnologies in both data communication and graphic displays it providesa heretofore unavailable manner of conveying multi-channel, real-time,quantified, graphical data to physicians at wireless remote displaystations in the form of handheld devices.

Reference is now made to FIG. 2 for a more detailed description of thehardware components associated with implementation of the system of thepresent invention to accomplish the task of communicating the necessarypatient physiological characteristics required by the remote physicianto carry out a decision with regard to patient condition. In the exampleof the present application, hospital 24 patient information is collectedinto the existing hospital patient data collection system and databasesystems 30 as shown in FIG. 2. In the present example, fetal heart rateand maternal contraction data 20 from patient 10 is gathered and passedthrough existing monitoring systems 22 known in the industry such as theCorometics Series Monitors offered by GE Healthcare. Existing clinicalinformation systems, such as the GE QS Perinatal system 32, the ClinicalComputer Systems, Inc. OBiX Perinatal Data system 36, the Hill-RomWatchChild system 36, and various similar obstetrics information systemsby Philips Medical Systems, provide further processing and storage ofthe collected patient data. In addition the data is passed through theAirStrip OB Data Collector 34 of the present invention (described inmore detail below) before being passed through Microsoft Message Queuing(MSMQ) 38 before finally being received and configured in the AirStripDatabase System 40 of the present invention.

From AirStrip Database System 40 the data/information is providedthrough a web service/firewall 42 to the Internet 50. From the Internet50 through a variety of Internet connectivity options 60 the informationis eventually passed to the local mobile devices 70 retained by theremote physician. Internet connectivity 60 may be provided by means ofsatellite receiver 61, cellular network 62, Bluetooth system 63, Wi-Fi(802.11) system 64, cable modern 65, DSL/dial-up 66 and PBX system 68.Each of these Internet connectivity systems 60 may provide thedata/information to the local devices 70 which may take the form of asmart phone 71, a PDA 72, a PDA phone 73, a Windows CE/.NET type device74, Tablet PC type device 75, or a PC/Laptop type device 76.

As mentioned above, the capabilities of the system of the presentinvention are established within the proprietary software applicationsoperable within the data collector/database systems within the hospitalfacilities and the remote wireless handheld devices carried by thephysicians. FIG. 3 provides an overview of the software system structureof the present invention that allows for the relatively complex dataassociated with healthcare monitoring systems to be transmitted,received, and displayed on relatively small and functionally simplehandheld devices. FIG. 3 represents a high level summary of the objectmodel of the software system of the present invention and identifies thevarious objects that are defined, passed, and characterized in theoperation of the system.

The fundamental object component of the system is OB Chart Sample Object110 which, as seen in the diagram, relates to the balance of the objectmodel components in the system. These include the Fetal Heart Rate Pane112 and Maternal Contraction Pane 114 both of which are sample objectsthat relate to base object Chart Pane 140. Chart Pane 140 primarilydefines Series Information Collection 148, but also defines Border Area142, X-Axis 144 and Y-Axis 146. X-Axis 144 and Y-Axis 146 relate to baseobject Chart Axis 150 which includes definitions for Axis Grid 152 andAxis Line 154.

OB Chart sample object 110 also characterizes Annotation Zone 116 whichitself defines Annotation Collection 118. OB Chart 110 further relatesto Real Time Information sample object 120 as well as Trend Informationsample object 122. The Strip Information base object 124 defines theData Point Collection 126 which itself incorporates Chart Symbol sampleobject 128. Ancillary Patient Information sample object 130 also isassociated with OB Chart 110.

Chart Renderer Interface 132 is associated with OB Chart 110 for thepurpose of providing the graphical interface for the informationcollected. Format Style sample object 160 provides the balance of thedisplay characteristics associated with the information being providedat the remote wireless device. A legend distinguishing therepresentations of a Sample Object, a Base Object, an Interface, and aCollection is also provided in FIG. 3.

The full details of the object model software system of the presentinvention shown and described in summary form in FIG. 3, are set forthin FIGS. 4A-4E. The various object components, parameters, variables,characteristics, methods, events, and properties associated with each ofthese objects are set forth. FIG. 4A shows in detail the characteristicsand functionality of OBChart object 110 and its connection to HRPaneobject 112 and TocoPane object 114. Likewise, AnnotationZone object 116and Annotation Collection 118 relate back to OBChart object 110 asshown. Finally in FIG. 4A, RealTimeInfo (StripInfoBase) object 120 andTrendInfo (StripInfoBase) object 122 are shown to relate back to OBChartobject 110 and to define StripInfoBase base object 124 (shown in detailin FIG. 4C).

FIG. 4B continues to show the characteristics and functionality ofOBChart object 110 and the balance of the display structure directed tothe remote wireless handheld device. Base object StripInfoBase 124derives DataPoint Collection 126 which in turn relates to ChartSymbolobject 128. PatientInfo object 130 also operates from OBChart object 110as shown. Finally in FIG. 4B, IChartRenderer interface 132 operates fromOBChart object 110 as shown.

FIG. 4C discloses in detail the structures of base objects ChartPane 140and ChartAxis 150. ChartPane 140 defines BorderArea object 142, AxisX(ChartAxis) object 144, and AxisY (ChartAxis) 146. AxisX (ChartAxis)object 144 and AxisY (ChartAxis) 146 in turn relate to ChartAxis 150which defines AxisGrid 152 and AxisLine 154. ChartPane 140 also relatesto SeriesInfo Collection 148 as shown.

FIG. 4D provides a detailed description of the FormatStyle object 160which governs the appearance of the display on the remote wirelesshandheld device. FIG. 4E provides an Object Diagram Key that comprises alegend for the object model diagrams of FIGS. 4A-4D. The key identifiesthe nomenclature for sample objects, base objects and interfaces. Inaddition, the key identifies the nomenclature for method connectionsthat return values and those that do not return values, read/writeproperties and the occurrence of events. Such nomenclature is consistentwith the practices in the art of structuring and describing objectoriented programming.

Reference is now made to FIG. 5 for an example of the type ofinformation that may be displayed utilizing the systems and methods ofthe present invention. In this particular example an OB chart strip isprovided to the remote physician in sufficiently clear detail to allowthe physician to make decisions and recommendations regarding a courseof action with the patient. In this diagram a first chart strip 202showing fetal heart rate is presented above a second chart strip 204showing maternal contractions (tocometry). A section of the dual stripdisplay is provided at a given moment on the wireless handheld device200 of the physician. As discussed above, the information streamed (withappropriate buffering) to the wireless device allows for a real timeview of the data for purposes of comparison and analysis and a trendview of the data whereby the physician may recall past data received toidentify and characterize trends. The typical wireless device configuredto receive the data associated with the present invention will havescreen controls integrated into the hardwire of the device or presentedon the screen of the device itself that will permit the physician tomove back and forth across the received data to identify trends. In theexample shown on FIG. 5 a characteristic association can be seen betweena maternal contraction and significant changes in the fetal heart rate.It is just such a characteristic association that the physician may beable to identify and characterize so as to provide a manner ofdiscerning a course of action for the patient even from the remotelocation.

Also seen in the display shown in FIG. 5 is the minimal textualinformation 206 provided on the screen while the graphical data is beingdisplayed. This information 206 may, in the preferred embodiment,contain location and biographical information about the patientsufficient for the physician to know at all times the individual patientassociated with the physiological data being viewed. The display wouldalso provide a clear indication of the timing of the information as withtime mark 208 to make clear whether the physician is reviewing real-timeinformation of recalling trend information. The time mark 208 may alwaysbe compared with the actual time shown on the text display 206.

Reference is now made to FIGS. 6A-6K for additional detail on thedisplay features of the present invention as well as the functionalityof the hand held device. FIG. 6A discloses a HIPAA compliant loginscreen that serves to protect the patient information and restrict it tothe appropriate physician. The physician would enter a user name andpassword as is typical in the art. FIG. 6B discloses a display screenthat allows the physician to select the facility of concern and thepatient of concern. This display is populated with all of the hospitalsthat the physician is associated with and under each hospital, all ofthe patients that the physician is responsible for at that hospital.

Once the physician selects the hospital and patient of concern the databuffering screen of FIG. 6C is presented providing the backgroundgraphic coordinate system and a buffering process alert while the systemdownloads the data. As can be seen from the programming structuredescribed above, a request is made from the handheld to the hospitalserver to transmit the data for a specific patient. This information isthen transmitted with the handheld device buffering the data to allowfor real-time viewing and trend viewing. Typically the system would takeabout 7 seconds to download up to 4 hours of data.

FIG. 6D provides the basic real-time viewing display wherein the datafor a particular patient is presented on the background gird with thetiming mark shown and the biographical information on the patient shown.In the preferred embodiment the tracing would move from right to leftacross the screen in a manner that mimics the view typically seen oninstrumentation located onsite in the health care facility.

FIG. 6E provides a screen shot of the semi-transparent data overlaywindow of the present invention that displays information about thepatient data being displayed and the manner of the data acquisition (thesensor characteristics, timing, etc.). With this functionality thephysician may confirm or verify the environment within which the patientdata was acquired and is being presented.

FIG. 6F provides a screen shot of an additional semi-transparent windowthat displays an image of the patient for recognition purposes. Both thepatient image window and the informational window are transparent enoughto allow discernment of the trace data displayed beneath them.

FIG. 6G provides a screen shot of pull-up or pull-down toolbar or menuthat allows the physician to select the composition of the display. Inaddition to the background image, the physician may choose to displaythe patient information (FIG. 6E), the patient picture (FIG. 6F), and/orthe data strip information (FIG. 6D). The physician may also choose tohave the display switch to a landscape viewing orientation (described inmore detail below).

FIGS. 6H & 6I provide screen shots that show the zoom in/outfunctionality of the system of the present invention (again referencethe detailed object model structure of the programming discussed above).In each case (zoom in or zoom out) the physician may take advantage ofviewing a trend (zoom out) or a specific data feature (zoom in) tofacilitate a judgment with regard to the condition of the patient.

FIG. 6J provides a screen shot of the variable speed scrollfunctionality of the data display of the present invention. In this viewthe physician is presented with a bidirectional, multilevel selectionbar that controls the direction and the scrolling speed for the databeing presented on the display grid. In this manner the physician maycustomize the viewing of the patient data to personal preferences or tothe specific situation that dictated the review of the data. With asmuch as 4 hours of data available within a download of information, thephysician may wish to quickly scroll through the data to a point whereanomalies occur and then slow the scrolling down to study the data inmore detail. This feature of the present invention permits thismodification of the scrolling to occur at the physician's direction.

Finally, FIG. 6K provides a screen shot of the data similar to thatshown in FIG. 6D but in a landscape presentation on the hand held devicedisplay. In this manner the physician may view either a greater amountof data (over a longer time period) in the display, or may view the dataset in expanded detail (across the time variable).

The system and method of the present invention as described in the aboveDetailed Description of the Preferred Embodiments and in the detailedObject Model Structural diagram of the drawing figures, lend themselvesto certain modifications that will be apparent to those skilled in theart, which modifications still fall within the scope of the invention. Avariety of handheld devices utilizing a number of different operatingsystems, could implement the system functionality of the presentinvention. Likewise, the system is not limited to the example given ofan OB chart (FHR and Toco) in that a variety of other patientphysiological characteristics could be displayed in the same or similarmanner. Those skilled in the art will recognize other combinations ofdata that would be useful to physicians who might be called upon to makepatient decisions from locations remote to the patient.

In some aspects, the present disclosure provides a system for the remotemonitoring of patient physiological data acquired from at least onepatient sensor, said patient physiological data capable of being plottedgraphically versus time, the system comprising: (a) a sensor datacollection system for collecting said patient physiological data; (b) ahealthcare facility data processing and data storage system serving toprocess and store said patient physiological data; (c) a first graphicaldata interface (GDI) system operating in conjunction with saidhealthcare facility data processing and data storage system, said firstGDI system for conditioning said patient physiological data fortransmittal across a wide area network and for reception and display ona remote data processing device; (d) a remote data processing deviceoperable for the reception and display of said patient physiologicaldata received from said wide area network; and (e) a second graphicaldata interface (GDI) system operating in conjunction with said remotedata processing device, said second GDI for conditioning said patientphysiological data for display on said remote data processing device.

In some aspects, said patient physiological data comprises obstetricpatient data comprising maternal uterine contraction data and fetalheart rate data.

In some aspects, said patient physiological data comprisescardiopulmonary patient data comprising respiration rate data and heartrate data.

In some aspects, said remote data processing device comprises a wirelessdevice for wireless connection to said wide area network.

In some aspects, remote data processing device comprises a dockingdevice for wired connection to said wide area network.

In some aspects, said remote data processing device comprises a personaldata assistant (PDA) having a display screen.

In some aspects, said remote data processing device comprises a smartphone communications device having a display screen.

In some aspects, said remote data processing device comprises a personalcomputer (PC) having a display screen.

In some aspects, said wide area network comprises the publiclyaccessible Internet.

In some aspects, said wide area network comprises a privately accessiblewired computer network.

In some aspects, said first graphical data interface conditions saidpatient physiological data by compressing said data.

In some aspects, said first graphical data interface conditions saidpatient physiological data by identifying and selecting anomalous eventswithin the data.

In other aspects, the present disclosure provides a method for theremote monitoring of patient physiological data acquired from at leastone patient sensor, said patient physiological data capable of beingplotted graphically versus time, the method comprising the steps of: (a)collecting said patient physiological data from the patient through saidat least one patient sensor; (b) processing said patient physiologicaldata so as to make said data amenable to storage on a digital storagedevice; (c) storing said patient physiological data on said digitalstorage device; (d) conditioning said patient physiological data forease of transmission over a wide area digital network; (e) transmittingsaid patient physiological data over said wide area digital network; (f)receiving said conditioned patient physiological data from said widearea digital network with a remote data processing device, said remotedata processing device having a display; (g) reconditioning saidreceived patient physiological data for ease of display on said remotedata processing device; and (h) displaying said reconditioned patientphysiological data on the display of said remote data processing device.

In some aspects, said patient physiological data comprises obstetricpatient data comprising maternal uterine contraction data and fetalheart rate data.

In some aspects, said patient physiological data comprisescardiopulmonary patient data comprising respiration rate data and heartrate data.

In some aspects, said step of conditioning said patient physiologicaldata comprises compressing said data for ease of transmission over saidwide area network.

In some aspects, said step of conditioning said patient physiologicaldata comprises identifying and selecting anomalous events within thedata.

In some aspects, said step of receiving said conditioned patientphysiological data comprises establishing a wireless data communicationlink with said wide area network and downloading said patientphysiological data from said wide area network through said wirelessdata communication link.

In some aspects, said step of receiving said conditioned patientphysiological data comprises establishing a wired data communicationlink between said remote data processing device and said wide areanetwork and downloading said patient physiological data from said widearea network through said wired data communication link to said remotedata processing device.

In some aspects, said step of reconditioning said received patientphysiological data comprises formatting said data for display on saidremote data processing device, said formatting step providing areduction in a volume of said data and a reduction in a period of timerequired to render said data on the display of said data processingdevice.

In some aspects, said step of displaying said reconditioned patientphysiological data comprises time sequentially displaying said data.

In some aspects, said time sequential display of said data comprises areal-time display of said data.

In some aspects, said time sequential display of said data comprises ahistorical trending time display of said data.

In some aspects, said time sequential display comprises a dynamicprogressive display of said data across the display screen of saidremote data processing device.

In some aspects, the method further includes the step of controlling thedisplay of said data to alternately present said data in real-time andin historical time, wherein said display may be scrolled across thedisplay screen of said remote data processing device by manipulation ofa scrolling control on said device.

In some aspects, the method further includes the step of controlling thedisplay of said data to alternately present said data in portraitorientation and in landscape orientation on the display screen of saidremote data processing device.

1.-26. (canceled)
 27. A method for the remote monitoring of patientphysiological data, the method comprising: receiving patientphysiological data, the patient physiological data having been collectedfrom a patient using at least one patient sensor; conditioning thepatient physiological data for ease of transmission over a wide areadigital network; transmitting conditioned patient physiological data inreal-time over the wide area digital network; receiving the conditionedpatient physiological data in real-time at a remote-handheld dataprocessing device, the remote-handheld data processing device executinga computer-executable application for displaying the patientphysiological data on a display of the remote-handheld data processingdevice; reconditioning the conditioned patient physiological data todisplay the patient physiological data on the remote-handheld dataprocessing device; and displaying, using the computer-executableapplication, the patient physiological data on the display of theremote-handheld data processing device.
 28. The method of claim 27,wherein reconditioning the conditioned patient physiological data isachieved using an application program interface (API) that provides thecomputer-executable application direct access to a video display memoryof the remote-handheld data processing device.
 29. The method of claim27, wherein additional patient physiological data is synchronized to theremote-handheld data processing device while displaying the patientphysiological data.
 30. The method of claim 29, further comprisingresponding to user input to the remote-handheld data processing deviceby adjusting displayed patient physiological data while receiving theadditional patient physiological data.
 31. The method of claim 27,wherein displaying the patient physiological data includes presentationof the patient physiological data in a software-generatedsemi-transparent overlay within the display.
 32. The method of claim 27,wherein the patient physiological data comprise multi-channel patientphysiological data that is simultaneously displayed in the display. 33.The method of claim 27, wherein reconditioning the conditioned patientphysiological data further includes formatting the conditioned patientphysiological data for reduced size presentation in the display.
 34. Themethod of claim 33, wherein formatting the conditioned patientphysiological data for reduced size presentation further includesproviding a reduction in a volume of the conditioned patientphysiological data and a reduction in a period of time required torender the patient physiological data in the display.
 35. The method ofclaim 27, wherein the patient physiological data comprises obstetricpatient data comprising maternal uterine contraction data and fetalheart rate data.
 36. The method of claim 27, wherein the patientphysiological data comprises cardiopulmonary patient data comprisingrespiration rate data and heart rate data.
 37. The method of claim 27,further comprising identifying and selecting anomalous events within thepatient physiological data.
 38. The method of claim 27, whereinreceiving the conditioned patient physiological data comprisesestablishing a wired data communication link and downloading theconditioned patient physiological data.
 39. The method of claim 27,wherein displaying the patient physiological data comprises timesequentially displaying the patient physiological data.
 40. The methodof claim 39, wherein the time sequential display of the patientphysiological data comprises a real-time display of the patientphysiological data.
 41. The method of claim 39, wherein the timesequential display of the patient physiological data comprises ahistorical trending time display of the patient physiological data. 42.The method of claim 39, wherein the time sequential display comprises adynamic progressive display of the patient physiological data across thedisplay.
 43. The method of claim 42, further comprising controlling thedisplay of the patient physiological data to switch the presentation ofthe patient physiological data between a real-time presentation and ahistorical time presentation.
 44. A system for remote monitoring ofpatient physiological data, the system comprising: a server system thatperforms operations comprising: receiving patient physiological data,the patient physiological data having been collected from a patientusing at least one patient sensor, conditioning the patientphysiological data for ease of transmission over a wide area digitalnetwork, and transmitting conditioned patient physiological data inreal-time over the wide area digital network; and a remote-handheld dataprocessing device that executes a computer-executable application fordisplaying the patient physiological data on a display of theremote-handheld data processing device and that performs operationscomprising: receiving the conditioned patient physiological data inreal-time, reconditioning the conditioned patient physiological data todisplay the patient physiological data on the remote-handheld dataprocessing device, and displaying the patient physiological data on thedisplay of the remote-handheld data processing device.
 45. The system ofclaim 44, wherein reconditioning the conditioned patient physiologicaldata is achieved using an application program interface (API) thatprovides the computer-executable application direct access to a videodisplay memory of the remote-handheld data processing device.
 46. Thesystem of claim 44, wherein additional patient physiological data issynchronized to the remote-handheld data processing device whiledisplaying the patient physiological data.
 47. The system of claim 46,wherein operations further comprise responding to user input to theremote-handheld data processing device by adjusting displayed patientphysiological data while receiving the additional patient physiologicaldata.
 48. The system of claim 44, wherein displaying the patientphysiological data includes presentation of the patient physiologicaldata in a software-generated semi-transparent overlay within thedisplay.
 49. The system of claim 44, wherein the patient physiologicaldata comprise multi-channel patient physiological data that issimultaneously displayed in the display.
 50. The system of claim 44,wherein reconditioning the conditioned patient physiological datafurther includes formatting the conditioned patient physiological datafor reduced size presentation in the display.
 51. The system of claim50, wherein formatting the conditioned patient physiological data forreduced size presentation further includes providing a reduction in avolume of the conditioned patient physiological data and a reduction ina period of time required to render the patient physiological data inthe display.
 52. The system of claim 44, wherein the patientphysiological data comprises obstetric patient data comprising maternaluterine contraction data and fetal heart rate data.
 53. The system ofclaim 44, wherein the patient physiological data comprisescardiopulmonary patient data comprising respiration rate data and heartrate data.
 54. The system of claim 44, further comprising identifyingand selecting anomalous events within the patient physiological data.55. The system of claim 44, wherein receiving the conditioned patientphysiological data comprises establishing a wired data communicationlink and downloading the conditioned patient physiological data.
 56. Thesystem of claim 44, wherein displaying the patient physiological datacomprises time sequentially displaying the patient physiological data.57. The system of claim 56, wherein the time sequential display of thepatient physiological data comprises a real-time display of the patientphysiological data.
 58. The system of claim 56, wherein the timesequential display of the patient physiological data comprises ahistorical trending time display of the patient physiological data. 59.The system of claim 56, wherein the time sequential display comprises adynamic progressive display of the patient physiological data across thedisplay.
 60. The system of claim 59, wherein operations further comprisecontrolling the display of the patient physiological data to switch thepresentation of the patient physiological data between a real-timepresentation and a historical time presentation.